MEDICARE: TRACY REHFELD NORTON MA, OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XN1300X	Neurorehabilitation Occupational Therapist	OT3498	CA

General Provider Information

NPI Number	:	1467667675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY REHFELD NORTON MA, OTR

Provider Business Mailing Address
First Line	:	9329 HUSTON RD
Second Line	:
City	:	CHATSWORTH
State	:	CA
Zip	:	91311-6329
Country	:	US
Telephone Number	:	818-590-8296
Fax Number	:

Provider Business Practice Location Address
First Line	:	4419 VAN NUYS BLVD
Second Line	:	SUITE 412
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-2910
Country	:	US
Telephone Number	:	818-386-1231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/08/2007

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